NEW YORK (Reuters Health) Apr 06 – In diabetic patients with neuropathy, limited joint mobility may contribute to the development of foot ulcers, according to a report in the April issue of Diabetes Care.
In a cross-sectional study, Dr. Stefan Zimny, of Evangelisches Krankenhaus Bethesda, Duisburg, Germany, and colleagues evaluated the role of limited joint mobility in causing high plantar pressures in the forefoot of diabetics with an at-risk foot. Included were 35 at-risk diabetic patients with foot neuropathy, 35 diabetic controls without neuropathy, and 30 nondiabetic controls.
The researchers assessed joint mobility at the ankle and metatarsophalangeal joints, using the FastScan plantar pressure analyzer to measure the pressure-time integrals as dynamic variables in each foot. Standard measures of peripheral neuropathy were also assessed.
Compared with the diabetic and nondiabetic controls, patients in the at-risk group had significantly reduced mobility at the ankle and the first metatarsophalangeal joints (p < 0.0001). In addition, the pressure-time integrals were significantly higher in this group compared with the other two groups (p < 0.0001).
«The vibration perception threshold was positively correlated with the pressure-time integrals in both feet of the diabetic patients,» the researcher report.
Based on these findings, Dr. Zimny’s group concludes that measuring joint mobility is «a simple and rather exact test to identify diabetic patients with an at-risk foot.»
«The method is simpler and less costly than measuring the plantar pressuring loading of the foot itself,» they add, «and might therefore be useful as a screening tool.»
Diabetes Care 2004;27:942-946.